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乏氧状态对膀胱癌全膀胱切除术后患者预后的影响
陈家璧,庄伟*,李毅宁
0
(福建医科大学附属第二医院泌尿外科,泉州 362000
*通信作者)
摘要:
目的 探讨机体乏氧状态对膀胱癌全膀胱切除术后患者预后的影响。方法 66例膀胱尿路上皮癌行全膀胱切除手术患者,分为机体乏氧状态组(OH组,n=19)和机体常氧状态组(NS组,n=47)。免疫组化检测肿瘤组织缺氧诱导因子1α(HIF-1α)表达和CD105标记的肿瘤微血管密度(MVD)。随访术后生存时间,对比两组患者临床资料,Kaplan-Meier法分析两组生存率,建立Cox模型分析各变量与生存时间的相关性。结果 OH组肿瘤组织HIF-1α表达的阳性率为89.5%(17/19),MVD值为53.1±19.0,中位生存时间为56个月;NS组表达的阳性率为66.0%(31/47),MVD值为40.1±15.2,中位生存时间为82个月;两组临床分期、Hb水平、HIF-1α表达、MVD值间差异有统计学意义(P<0.05)。肿瘤分期高、机体乏氧、HIF-1α高表达和肿瘤高MVD值患者的生存期较短,而高Hb患者的生存期延长(P<0.05或P<0.01)。结论 机体乏氧状态下的膀胱癌组织HIF-1α表达上升,肿瘤微血管密度增加,不利于患者预后。
关键词:  缺氧  膀胱肿瘤  预后  缺氧诱导因子1,α亚基  CD105
DOI:
投稿时间:2013-05-09修订日期:2013-07-22
基金项目:
Effect of hypoxia on postoperative prognosis of radical cystectomy in patients with bladder cancer
CHEN Jia-bi,ZHUANG Wei*,LI Yi-ning
(Department of Urology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian, China
*Corresponding author.)
Abstract:
Objective To explore the effect of hypoxia on postoperative prognosis of radical cystectomy in patients with bladder cancer. Methods A total of 66 patients with bladder urothelial cancer undergoing radical cystectomy surgery were divided into hypoxia group (OH group, n=19) and the normoxic group (NS group, n=47). Immunohistochemical examination was used to examine the expression of HIF-1α and CD105-assessed microvessel density (MVD). The survival of the patients was followed up and the clinical data of the two groups were compared. Kaplan-Meier analysis was used for analyzing the survival of the two groups, and a Cox model was established to analyze correlation of each variable with the survival time. Results In the OH group, the positive rate of HIF-1α was 89.5% (17/19) in the tumor tissues, the MVD value was 53.1±19.0, and the median survival time was 56 months; the corresponding values in the NS group were 66.0% (31/47), 40.1±15.2, and 82 months, respectively. The clinical stages, Hb levels, HIF-1α expression, and MVD values were significantly different between the two groups (P<0.05). Advanced tumor stage, hypoxia state,high HIF-1α expression and high MVD value in tumor tissues were associated with a shorter survival of patients, and high Hb was associated with a longer survival of patients (P<0.05 or P<0.01). Conclusion Hypoxic state can lead to increased HIF-1α expression and microvessel density in bladder cancer tissues, which is harmful for patient prognosis.
Key words:  anoxia  urinary bladder neoplasms  prognosis  hypoxia-inducible factor 1, alpha subunit  CD105